What is Sleep Apnea?

Sleep apnea is a serious sleep disorder in which you have one or more pauses in breathing or shallow breaths during sleep. Breathing pauses can last from a few seconds to minutes. People with untreated sleep apnea stop breathing several times during their sleep, sometimes hundreds of times during the night. In the morning they will not be aware of the disturbances in their sleep. When your breathing pauses or becomes shallow, you'll often move out of deep sleep and into a light sleep. As a result, the quality of your sleep is poor, which makes you tired during the day.

Types of sleep apnea

Obstructive sleep apnea (OSA)

This is the most common type of sleep apnea, where breathing is paused temporarily due to obstructed airways from relaxed soft tissues in the back of the throat during sleep. When the muscles relax, your airway narrows or closes as you breathe in, and you are unable to get an adequate breath in. This may lower the level of oxygen in your blood. You may make a snorting, choking or gasping sound. This pattern can repeat itself several times, all night long. These disruptions impair your ability to reach restful phases of sleep, and you'll probably feel sleepy during the day times. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, some people with this type of sleep apnea think they sleep well all night.

Central sleep apnea

This type of sleep apnea occurs when your brain does not send proper signals to the muscles that control breathing hence there is no effort to breathe for short periods of time. You may awaken with shortness of breath or have a difficult time getting to sleep or staying asleep. It is usually seen in patients with central nervous system dysfunction, such as following a stroke or in patients with heart failure.

What are the signs and symptoms of sleep apnea?

• Excessive daytime sleepiness (hypersomnia)
• Loud snoring, which is usually more prominent in obstructive sleep apnea
• Episodes of breathing cessation during sleep witnessed by another person
• Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
• Awakening with a dry mouth or sore throat
• Morning headache
• Sexual dysfunction
• Difficulty staying asleep (insomnia)
• Cognitive impairment, such as concentration problems, irritability or forgetfulness

What are the risk factors of sleep apnea?

Risk factors for obstructive sleep apnea (OSA)

• Overweight
• Male gender
• Older age
• Smoking
• Family history
• Use of alcohol, sedatives or tranquilizers

Risk Factors for central sleep apnea

• Heart Disorders
• Stroke
• Older age
• Using medications, such as narcotics

How is sleep apnea diagnosed?

Your physician may make an evaluation based on your signs and symptoms and may refer you to our Sleep Disorder Center to conduct a sleep study. During this test, wires and sensors will be connected to your head, face, chest, abdomen, arms and legs to monitor your breathing, heart, brain activity, arm and leg movements and blood oxygen levels while you sleep.

What are the treatment options for sleep apnea?

Treatments for central sleep apnea may include:

• Treatment for associated medical problems: possible causes of central sleep apnea include heart or neuromuscular disorders and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.
• Supplemental oxygen: using supplemental oxygen during sleep may help central sleep apnea.
• Adaptive servo-ventilation (ASV): this more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. This machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing.
• PAP devices: CPAP (Continuous Positive Airway Pressure) and sometimes Bi-Level (BPAP) devices are used to treat your apnea.

Treatments for OSA may include:

• Conservative treatment: lifestyle modifications, avoiding alcohol, using tennis ball T-shirts, etc.
• Mechanical therapy: using CPAP or BPAP devices.
• Surgery: there are many types of surgical procedures, such as tonsillectomy and adenoidectomy, Uvulopalatopharyngoplasty and Somnoplasty.

Please see other Cleveland Clinic Abu Dhabi sleep apnea handouts for further information regarding treatment options.